Cadre réservé à l’administration de l’UPEMLV · Web viewFrench certificate: Yes No If yes, please include it in your application documents (DELF, DALF, TCF, TEF) English test:

Université Sorbonne Paris CitéInternational Scholarship Programme MIEM

Application Form 2016 / 2017

GENERAL CONDITIONS :

- Eligible Training at MIEM scholarship program:

- Engineers Training SupGalilée - Master COLEDI: Language Sciences, contrastive specialty, vocabulary, speech- Master EPOG: Economic Policies in the Age of Globalisation- Master Mathematics, Basic Mathematics specialty- Master MOSS: Management of health and social organizations

- The amount of the scholarship MIEM is 10 000 € for a period of one year.- It is your responsibility to check that the file is completed with all attached documents.- Lack of supporting documents or non-compliance of the internal policy of the University Paris 13 implies the automatic refund of any scholarship.

Documents to complete the application: This application form Your complete and up to date curriculum vitae Courses attended and transcripts for the past three academic years, including the

current year copies of your diplomas (NB: selected students will be asked to bring the original diplomas on arrival).

Language certificate. Two letters of reference from academic or research staff, of which at least one

belongs to your home university, with their exact and complete contact details (see annex 1).

Registration certificate for 2013-2014 (if presently enrolled in a higher education institution).

A photocopy of your passport. An education plan for Master or PHD degree (see annex 2)

Submission of applications:

The complete application files, containing this application form and the complementary documents, are to be sent in a single .pdf file to the International and European Relations Office (SREI)

Deadline: May 2, 2016. Incomplete applications will not be processed.

Contact: Emmanuel BENOIT - [email protected]

Université Sorbonne Paris Cité 1/8

mailto:[email protected]

Information concerning the applicant

PERSONAL INFORMATION:

Gender: F M

Last name: _________________________________________________________________________________________

First name:

_________________________________________________________________________________________

Date of birth: ___ / ___ / _______ Place of birth: _____________________ Nationality:

___________________________

Mailing Address for correspondence:

___________________________________________________________________

Post code: ________________ City: ___________________________ Country:

_________________________________

Phone number: ____________________________________ Mobile

number:___________________________________

E-mail address:

______________________________________________________________________________________

ACADEMIC RECORD

Home institution name:

_______________________________________________________________________________

Department/Faculty:

_________________________________________________________________________________

Address: ___________________________________________________________________________________________

___________________________________________________________________________________________________

Phone number: ________________________________ E-mail address:

_______________________________________ Website:

___________________________________________________________________________________________

Detail your education during the last 4 years. Include details of qualifications to be awarded:

College / University /Awarding

body/Country/CityName of unit Main subject(s)

studiedDegree/Diploma obtained/date of

awardMarks Rank*


2014-2015 ... ... ... ... … …

2013-2014 ... ... ... ... … …

2012-2013 ... ... ... ... … …

2011-2012 ... ... ... ... … …

* For instance 3rd out of 58, or ranked 5%, etc


Please explain the grading system (for instance A,B, C…, A being the highest mark)

.........................................................................................................................................................................

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LANGUAGE SKILLS:Your level of competence in French and English:

French EnglishSpoken ability: A1/A2 B1/B2 C1/C2 A1/A2 B1/B2 C1/C2

Written ability: A1/A2 B1/B2 C1/C2 A1/A2 B1/B2 C1/C2

French certificate: Yes No If yes, please include it in your application documents (DELF, DALF, TCF, TEF)

English test: Yes No If yes, please include it in your application documents (TOEFL, IELTS)

Do you intend to take French language courses at Paris 13 ?

YES NO

INFORMATION ABOUT YOUR PERIOD OF STAY AT PARIS 13:

Graduate level at Paris 13 in 2015/2016: Master 1 Master 2

Master attended at Paris 13 (full name):

______________________________________________________________

___________________________________________________________________________________________________

Planned period of the mobility:

From : ______ / ______ / __________

Till : ______ / ______ / __________


APPLICANTS’ DECLARATION: I hereby certify that the information contained in this application is accurate and complete.

Place __________________ , date ___________

Applicant’s signature preceded by thehandwritten words « lu et approuvé »

Service des Relations Européennes et InternationalesProgramme de bourses MIEM :

Université Paris 13 – Bâtiment de l’IUT – Bureau L10199, avenue Jean-Baptiste Clément

93430 VilletaneuseContact : [email protected] ; Fax : + 33 (0) 1 49 40 39 22


mailto:[email protected]

ANNEX 1:

REFEREES

Please indicate at least 2 academics of which at least one from your home institution that may

provide references for your application:

1. Name and position: .....................................................................................................................................

.........................................................................................................................................................................

Address: ..........................................................................................................................................................

.........................................................................................................................................................................

Phone number: ............................................... Fax number: ..........................................................................

E-mail address: ............................................... Website: ................................................................................

2. Name and position: .....................................................................................................................................

.........................................................................................................................................................................

Address: ..........................................................................................................................................................

.........................................................................................................................................................................

Phone number: ............................................... Fax number: ..........................................................................

E-mail address: ............................................... Website: ................................................................................


ANNEX 2:

EDUCATION PLAN

Writing about your education plan Why did you choose France for your studies? Please explain what aspects of the selected master’s programme are most appealing to you.

After your master’s studies do you plan to undertake a PhD thesis? Yes No If yes, please give some more details about your plans: ..........................................................................................................................................................................................................................................................................................................................................................................If not, what are your future career plans? : ...........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................


Have you already defined the research topic for your Master internship? Yes No yet

If yes, please detail your research interests (max. 1 page).

Please explain how this master programme at Paris 13 and your previous studies could help you to achieve your goals.
